Wednesday, October 30, 2013

Why I'm happy about healthcare reform

I signed up for a new healthcare plan Monday on the Covered California website. And I'm delighted about it, but not because of the insurance itself.

I'm certainly not excited about the website. It took me hours to navigate, kept breaking down, and because of a typo I didn't notice when I first signed in, it will apparently call me by the wrong name forever. But that's all behind me.

I'm delighted because of something I'm not seeing any major media head talk about:

I'm not afraid of my health insurance company anymore

Maybe you've had the same job for 20 years and your health insurance was never in question. Me, I've had five full-time jobs in the past 15 years. Two of the companies don't exist any more. At the other three, the job I had doesn't exist anymore. It's a tough era to be a writer. Every time I left a job, I was afraid of my health-insurance company.

Once I took a buyout from a job and immediately applied for individual healthcare insurance. I conscientiously listed every doctor visit I'd made over the past five years while on the terrific company plan; have the flu, see the doctor, because the copay is low enough.

I was turned down because I had visited a doctor three times in the previous two years.

I don't have any ongoing serious conditions (except logorrhea), but I wasn't healthy enough to buy insurance. I paid more money than I wanted to for Cobra until it ran out, and spent that entire period terrified of going to the doctor.

The next time I needed to apply for individual insurance, I was accepted. Yay! I bought a high-deductible plan which basically meant I pay for all medical services myself, unless something really serious happens to me, which hasn't yet. Fine: I just didn't want a medical crisis to bankrupt me. I was happy to pay as I go and pay a (surprisingly high) monthly fee for, essentially, medical bankruptcy protection.

Then, as soon as healthcare reform passed, my healthcare company sent me a frosty letter informing me that my plan wasn't grandfathered in and I could be booted from it at any time.

So once again, I was afraid to go to the doctor. What if the insurance company held it against me? What that really means is, I was afraid of my health insurance company.

I should add that I have always been terrified, even when covered, about "pre-existing conditions." What if I got cancer, like Walter White? Would the insurance company claim it developed when I was covered by some other insurance company? Would they get together and claim the first cells went rogue during a month I was without insurance? They did that all the time; it's a major reason we have health-care reform. This is no joke, I worked with a man who had to divorce his wife while she was dying of cancer because otherwise they would both be bankrupt. He told me she begged him to divorce her, so he did. He wept when he told me. I can still hear it.

My insurance company sent me threatening letters for months after Obamacare passed. We're just reminding you that we can bump you at any time. Have a nice day -- and if you do get sick, hahahaha good luck. Oh, and don't forget to send that monthly premium payment.

Then, about five months ago, the tone of the letters abruptly changed. My health insurance company was aware that I have options. The company values our relationship. The company is available any time to give me advice about the new insurance market. Here's a personal adviser for you. May we schedule a call?

When I was in high school, I had had a crush on a girl for about a year who never gave me a second glance -- until she was struggling with chemistry. Then suddenly she wanted to be lab partners. That's exactly how that felt.

Then my insurance company sent me a brochure outlining my new replacement plan. I saw some writer complaining on Forbes about this: I think we got the same brochure. It sucked: I was going to have to pay 25% more, and my deductible would actually be higher. The creepily friendly tone persisted, but still, ecch! This is healthcare reform? How can I have been crazy enough to support it?

Finally on Monday, I got the Covered California site to work. And now everything is hunky-dory: I'm going to pay 40% less, my deductible is lower than before, and I'll actually be able to have office visits before the deductible with a reasonable copay.

I'm not going to be afraid to go to the doctor anymore.

But it's much bigger than that. Did I mention I've had a few jobs? And I spend a lot of time between jobs as a freelance writer. Health insurance was always an issue I had to consider. I did not have true economic freedom. I am not a person ruled by fear, but a more conservative person would try to stay in some jobs just to keep the insurance. I hear this all the time.

I'm not afraid of my health insurance company anymore.

I can leave one plan and next year, I can get health insurance again. They can't say no. I can move to another state, and I can get health insurance again. If I get really sick, the insurance company can't drag its feet and claim the illness developed under somebody else's watch.

Lost in the debate over health-insurance reform, lost in the charts and graphs and website complaints and Tea Party filibusters, is what health-insurance reform is all about:

Freedom

Today, I feel free. Free to move where I want, to work where I want. Free from worry. Free from fear.

13 comments:

I'm by no means an ideologue for the American Left. However, when I read stories like this, I'm disgusted that it is so problematic and tenuous to access healthcare. I'm even more disgusted when I see the teabrains and the GOP (Gang of Pr*cks) using their claims of the destruction of freedom, and fear mongering (somehow we will all be put in front of death panels, governed by sharia law, executed on by socialist, kenyan, nazis, who want to ban the celebration of xmas, and abort every fetus that they can detect with their secret abortion rays - it's true you know)

Make no mistake, the ACA has its problems, beyond just the technology. However, the ravages of age, genetic mutations, car accidents, viruses..., don't discriminate and even the relatively well off in this country can be financially destroyed by the scale of medical bills and the lack of transparency in service costs. So it would seem that the teabrains, et al, would be well incented to work with their mortal enemies (amazing) and repair the ACA (or give in to single payer) so that they don't have to risk the bottom falling out.But alas, no. Because, you know FREEDOM; and they don't want the black dude in charge; let alone succeed.

Oh, BTW, what new name did the CC give you? You do realize that it wasn't a typo. It was the government deciding what your name is. This was determined by an algorithm which is, also, governed by sharia law.

I'm right there with you on this one, Blake! Healthcare in the U.S. makes me sick. We've been through the whole pre-existing conditions hassles, and my son's autism has been a constant fight. We were paying more for insurance than our mortgage, which doesn't quite compute to me. But I think this whole issue comes down to which side of the fence you're on. If you're an owner of a business with a bunch of employees, you probably hate ACA, but if you're like me - barely getting by and self-employed - ACA is a little breath of fresh air.

I don't know if I buy that ACA is bad for business, at least not in the long term. Thinking about my personal situation, we've been lucky that my wife's teaching job provides benefits, of course we pay close to $1k per month. My wine startup is doing well enough to seem like a good long term bet, but if she had lost her job (a very real issue in the land of tenure and budget cuts in California) I might have had to choose to close my startup and find a job that provided benefits. There's a whole different set of issues here, but I do think that there are a number of complex issues at play, but too much fear mongering going on to have a real discussion about if ACA is working or not.

As ostensibly one the few conservative readers of your blog, I feel obligated to put in my two cents. I’m truly happy for you that you feel much more secure with your current health insurance. I’m also glad your premium is lower. However, there are many examples of others whose premiums are higher, much higher.

I’m glad you feel you have more freedom. We don’t all feel that way. There are those who want the freedom to live without health insurance. Those who choose to do so will be fined ever-increasing amounts.

I don’t know if you qualified for any subsidies, but that could be a factor in your premium being lower. Regardless, the economics of the situation are pretty straightforward. When the insurance company is required to take on more risk (and ultimately more expense), in the form of preexisting conditions, lower deductibles, or greater levels of coverage, something must give – the premium must go up.

The fact is, under Obamacare, one segment of society is now being forced to pay for a portion of the health insurance of another segment of society. For many Americans, this is not more liberty, it is less. And, the Affordable Care Act is just the beginning. Obama’s explicitly stated goal is a single-payer system, where all health care is administered by the government. All of this requires one segment of society to be compelled by government force to pay for the health care of another segment of society. While the goal of such a system is laudable, the method by which it is achieved is morally repugnant.

You may make the argument then that all taxes possess the same moral dilemma, and I would agree that many of them do. Nevertheless, I would argue that, as much as is practically possible, taxes should be based upon individual usage and benefits received and transfers of property from one citizen to another, should be entirely avoided. There are many areas where the lines of demarcation are a bit fuzzy, and we can debate how best to deal with them, the Affordable Care Act is not one of them.

Kent: There is really no such thing as freedom to live without insurance. Should you get very sick or be in a traumatic accident, you will be treated, after the loss of all your funds, at public expense.

This has been happening for decades in the US. People use the emergency room as a doctor's office, and they do it because they don't have an established healthcare plan and somewhere to go when they need to see the doctor.

You're already paying for this. Getting everyone on a managed healthcare plan is a better alternative. It isn't and won't be perfect; there are unforeseen consequences. But the present system we have is inefficient and barbaric.

Blake: Those aren't the people I was talking about. I spent the first five years of my adult life with no health insurance, by choice, as do most young adults. I was in excellent health and, for me, it was more economical to be on a pay-as-you-go plan. It was a good choice for me and my wife. I don't recall either of us requiring any medical treatment during those five years. Had we needed care during that time, we would not have expected someone else to pick up the tab.

Under Obamacare, making that choice will involve a tax penalty, small initially but growing significantly in the near future.

There are others who have plenty of money to cover even catastrophic health care expense and choose to be without insurance, paying for everything out of pocket. These people will also be subject to a tax penalty.

Be that as it may, I object on moral grounds to a system in which some citizens are forced to pay for the healthcare of other citizens. With regard to the cost of the uninsured visiting emergency rooms already being absorbed by paying consumers of health care: greatly expanding what is already a grossly unfair practice is hardly the answer.

Despite someone who has very good healthcare through my employer, I don't mind one bit kicking in a little more on my contribution if it means that some poor guy who lost his job as a result of an economic catastrophe caused by the worst examples of human greed and self-centerdness can get treatment for his 8 yr old kid with Leukemia. That's what a civilized society should strive for! The naysayers on ACA still have no ideas of their own when it comes to alternatives. At least now there is a system that can be tweaked as we go along.

Jonas: That has essentially been my POV on the bill after my disappointment of it not offering more of a single payer system eased.

Not only is it not perfect, I'm sure there will be unforeseen consequences. And I'm sure we'll hear all about those, with little coverage of anything good.

Since writing this post, I tried to post a comment on a New York Times story that listed several people whose healthcare plans were canceled, and how unhappy they were about it.

My comment was rejected. Not by Fox, by the New York Times.

But at least, despite the drumbeat of negativity, we have taken a step toward universal coverage. When I think about the kind of patients you mention being denied coverage because it's called a pre-existing condition, or because their father got laid off, I can only come up with one word: Barbaric.

I think there is one thing that Kent is completely missing-a frank discussion about who the uninsured people are, who will be gaining coverage.

Look, we know that younger people are cheaper to insure (plenty of people have purported facts in this argument that haven't yet been proven as true). It's a running joke within the insurance industry that if a company wants to save money on their corporate health insurance, offering gym memberships is nice, hiring a lot more 18 year old males is better (they're basically free and bring your # of insured up, while bringing average costs down).

Adding those people to plans does not increase the costs of everyone. It's counter intuitive, but larger number of people (you know, supply demand curve) affects price. That's why a school district often is paying $2k for a complete family plan these days while Medicare pays about $1k for the exact same plan the minute that the husband and wife turn 65 (did their health just get 50% better based on aging an additional day?)-doctors and hospitals are willing to discount their rates to get at the largest group of people possible.

Before we say that we know for certain that more insured people means that costs go up.....how do you know that? What's the average age of people gaining insurance?

People can argue about the correct balance between a societal safety net and the relative lack of one, I don't think reasonable people think that a safety net in any form shouldn't exist.

At least no one who's reasonable.

Also, I wouldn't assume that only progressives or liberals read this blog. Most of the health care polls I've seen show a clear split in terms of age range and the implement of ACA-younger people, regardless of political affiliation seem to think it's a good idea.

Lastly, I'll just say that I think we can all agree that the health care situation in the country needs improvement, I don't think another few decades of the same general ideas gets us improvements, unless you're talking about hospital profits and examples where doctor's at University hospitals earn more than the president of the University they work for.

Blake: It’s called the fundamental right to personal property. The law does not allow me to enter your home uninvited and take some of your property, even if I intend to give it to someone in need. Why do we prohibit such actions? Because we consider it immoral to take something that belongs to someone else, even if the purpose of the theft is a noble and “moral” cause.

You are putting words into my mouth. I did not say I object to “helping pay for your neighbors to get health care.” I said I object to property being taken from citizens against their will in order to do so. If charity is not voluntary, it is not charity, it is theft.

As to young people living without health insurance: your statement seems to be saying that people sometimes take unwise risks and the government should force them not to take those risks. This is not my idea of liberty. I don’t want or need government making decisions for me regarding how I am to manage my financial affairs. I don’t consider a young, healthy person being without health insurance to be an error. It’s a reasonable financial choice. We make these kinds of financial choices throughout our lives, each time making a judgment about probabilities and cost. We should have the freedom to make them on our own without government mandates. The reality is the young are mandated to have health insurance, not because they need coverage, but because the system doesn’t work without premiums being paid by people who never go to the doctor. In other words, we need their money. (Mark: I am “completely” aware of who will be “gaining” coverage.)

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